Complaints

NSCDN addresses complaints made about a dietitian’s practice. The Act, Regulations, and policies prescribe a process to address the complaints fairly and objectively. Complaints may address incompetence, incapacity, or misconduct. Section 2 (ad) of the Dietitians Act (2009) defines professional misconduct. 

Standards of practice describe competent, collaborative, ethical, and safe practices applicable to dietitians in multiple practice areas and settings. Standards set the minimum expectation by which performance can be measured in a complaints process.

Upon receipt of a written complaint, the NSCDN informs the dietitian about the complaint and requests a written response. Following the dietitian’s response, an investigation is initiated. Unless the complaint is deemed frivolous or vexatious, the complaint is addressed through the professional conduct process. This process is an evidence-based, objective, fair, and timely complaints process.

Practice Illustration: Mrs. Ricci sent a written complaint to the College about a dietitian named Julia. Mrs. Ricci was concerned about the nutritional care Mr. Ricci received while admitted for respite in a long-term care facility. While at the facility, Mr. Ricci developed an infection and lost weight over two weeks. They believed the dietitian needed to create a nutrition care plan to provide enough nourishment.

NSCDN sent the written complaint to Julia and asked for a written response. The dietetic competencies that Julia may have failed to meet were identified, including:

• Assessment of nutrition-related risks and needs.
• Development of nutrition care plans.
• Management of the implementation of nutrition care plans.
• Evaluation and modification of the nutrition care plan, as appropriate.

NSCDN obtained and reviewed Mr. Ricci’s medical chart and interviewed Mr. and Mrs. Ricci and the patient's physician.

The investigation revealed that the nutrition care assessment and care plan were appropriate, and that the dietitian had appropriately monitored and evaluated the intervention. The dietitian had documented their actions to address that the patient failed to consistently receive the high energy, high protein nutritional supplements as ordered.

A panel of the NSCDN Complaints Committee, who had never worked with Julia nor had any potential bias, assessed the investigation's findings. They did not find Julia to be incompetent in their practice. The facility was advised of the findings, and recommendations were made to the facility.

Mrs. Ricci and Julia each received the complaint findings in writing, which outlined the reasons for the decision.

Definitions:

Incompetence: the display of lack of knowledge, skill, or judgement in the respondent's care of a patient or delivery of dietetic services that, having regard to all the circumstances, rendered the respondent unsafe to practice at the time of such care of the patient or delivery of dietetic services or that renders the respondent unsafe to continue in practice without remedial assistance (Dietitians Act, 2009).

Incapacity: the status whereby a respondent, at the time of the subject-matter of a complaint, suffered from a medical, physical, mental, or emotional condition, disorder or addiction that rendered the respondent unable to practice with reasonable skill or judgment or that may have endangered the health or safety of patients (Dietitians Act, 2009).